Fractures of the Fifth Metatarsal
Fractures are common in the 5th metatarsal bone of the foot. This bone lies on the outside of the foot, behind the 5th toe (pinky toe). Generally, 2 types of fracture can happen at the 5th metatarsal, avulsion fractures and Jones fractures.
Avulsion fractures of the 5th metatarsal occur when a piece of bone is pulled off the base portion of the 5th metatarsal bone by the peroneal brevis tendon that attaches at that site. This can occur from ankle sprains. Jones fracture occurs in an area of the 5th metatarsal bone that receives less blood from the surrounding arteries. This makes the bone more difficult to treat and heal. For more information regarding Jones fracture, please refer to the Jones Fracture section.
Symptoms:
Fracture of the 5th metatarsal will cause pain at the fracture site, with associated tenderness, on the outside of the foot. Patients might experience difficulty walking with bruising at the site.
Diagnosis:
A complete history, and careful physical examination is important. The location of the pain is key to identifying a 5th metatarsal fracture. X-rays of the foot for further assessment of the metatarsal bone is recommended.
Treatments:
Conservative treatment for metatarsal fracture is often recommended if the fracture is nondisplaced (non-shifted), or if the patient is not an active athlete. Initial conservative treatments can include the following.
After implementing the initial treatment, if symptoms do not improve, or healing is delayed, the following might be implemented.
Fractures are common in the 5th metatarsal bone of the foot. This bone lies on the outside of the foot, behind the 5th toe (pinky toe). Generally, 2 types of fracture can happen at the 5th metatarsal, avulsion fractures and Jones fractures.
Avulsion fractures of the 5th metatarsal occur when a piece of bone is pulled off the base portion of the 5th metatarsal bone by the peroneal brevis tendon that attaches at that site. This can occur from ankle sprains. Jones fracture occurs in an area of the 5th metatarsal bone that receives less blood from the surrounding arteries. This makes the bone more difficult to treat and heal. For more information regarding Jones fracture, please refer to the Jones Fracture section.
Symptoms:
Fracture of the 5th metatarsal will cause pain at the fracture site, with associated tenderness, on the outside of the foot. Patients might experience difficulty walking with bruising at the site.
Diagnosis:
A complete history, and careful physical examination is important. The location of the pain is key to identifying a 5th metatarsal fracture. X-rays of the foot for further assessment of the metatarsal bone is recommended.
Treatments:
Conservative treatment for metatarsal fracture is often recommended if the fracture is nondisplaced (non-shifted), or if the patient is not an active athlete. Initial conservative treatments can include the following.
- Rest: Stay off the injured foot. Walking may cause further injury.
- Ice: Apply an ice pack to the injured area. Place a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Compression: An elastic wrap should be used to control swelling.
- Elevation: The foot should be raised slightly above the level of your heart to reduce swelling.
After implementing the initial treatment, if symptoms do not improve, or healing is delayed, the following might be implemented.
- Immobilization. Depending on the severity of the injury, the foot is kept immobile with a cast, cast boot or stiff-soled shoe. Crutches may also be needed to avoid placing weight on the injured foot.
- Bone stimulation. A pain-free external device is used to speed the healing of the fracture. Bone stimulation may be used as part of the treatment or following an inadequate response to immobilization.
- Surgery. If the injury involves displaced (shifted) bone, or multiple breaks, then surgery is required. Also, if the patient is an athletic individual, then surgery is often recommended.